| Hyperthyroidism and seizures during pregnancy. | |
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MedLine Citation:
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PMID: 7612094 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Untreated hyperthyroidism during pregnancy is associated with increased maternal and perinatal morbidity. Some features of this disease simulate preeclampsia, which may encourage delivery of the fetus. We report a case of poorly controlled hyperthyroidism associated with generalized seizures, where patient management was directed at a diagnosis of preeclampsia-eclampsia. Although the presence of eclampsia and marked hyperthyroidism is very rare, this case illustrates the importance of aggressive medical management of hyperthyroidism. A 17-year-old gravida was diagnosed with hyperthyroidism at 15 weeks' gestation. At 26 weeks' gestation, she was admitted to the hospital after noting edema of the upper and lower extremities, nausea, vomiting, shortness of breath, and a cough. At admission, she was hypertensive, tachycardic, and dyspneic. The patient was believed to have preeclampsia with pulmonary edema complicated by hyperthyroidism. We initiated magnesium sulfate therapy and administered several bolus doses of hydralazine, with little effect on blood pressure. Oliguria was noted, and a pulmonary artery catheter was inserted. Hours later, generalized seizure activity occurred, and a decision was made for abdominal delivery. Postoperatively, cardiovascular function stabilized. On postoperative day 3, we received the results of the thyroid function tests obtained at admission, which suggested a markedly hyperthyroid condition. Untreated or poorly treated hyperthyroidism may present a clinical picture similar to preeclampsia. In our case, both disease processes coexisted in their severest forms. It is possible, although completely unproven, that a relationship exists between poorly controlled hyperthyroidism and preeclampsia-eclampsia. More importantly, accurate diagnosis of hyperthyroidism should lead to prompt medical or surgical management, thereby decreasing maternal and perinatal morbidity. |
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Authors:
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D C Mayer; J Thorp; D Baucom; F J Spielman |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: American journal of perinatology Volume: 12 ISSN: 0735-1631 ISO Abbreviation: Am J Perinatol Publication Date: 1995 May |
Date Detail:
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Created Date: 1995-08-24 Completed Date: 1995-08-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 192-4 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill 27599, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Diagnosis, Differential Female Humans Hyperthyroidism / complications, diagnosis*, drug therapy Pre-Eclampsia / diagnosis Pregnancy Pregnancy Complications / diagnosis*, drug therapy Propylthiouracil / administration & dosage Seizures / etiology* |
| Chemical | |
Reg. No./Substance:
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51-52-5/Propylthiouracil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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